As many as 1 in 4 doctors and up to 15 percent of nurses practicing in the U.S. are born outside the U.S. and received their degrees from non-American medical schools, according to a new RAND Corporation study.
The findings, published in the journal Health Affairs
, indicate the ranks of foreign-born and trained medical professionals are on the rise and play a vital role in the U.S. healthcare workforce.
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The two groups fill important gaps in the healthcare system, particularly among primary care physicians, nurses in hospital settings, and other areas with worker shortages, according to the study. But the researchers also warned that the continuing reliance on foreign-educated and foreign-born health workers may reduce incentives for the nation to address problems such as the inadequate supply of primary care physicians and lead to a less-stable U.S. medical workforce.
"There is no cohesive national policy that outlines a strategy for how to incorporate foreign-born and foreign-trained health professionals into the U.S. workforce," said Peggy G. Chen, M.D., the study's lead researcher and an associate scientist at RAND, a nonprofit research organization. "Policy changes could increase the stability of the nation's health care workforce, while also improving the experiences of foreign-born health workers."
Among the study's key findings:
- Doctors educated outside the U.S. account for 25 percent of the nation's physician workforce, with most from India, the Philippines, Pakistan, Mexico, and the Dominican Republic.
- Foreign-born registered nurses account for 12 percent to 15 percent of the RNs in the United States, with 5.4 percent both foreign born and foreign educated. Most are from the Philippines, Canada, India, the United Kingdom, and Nigeria.
- Among direct care workers, such as nursing aides and home health aides, foreign-born individuals account for 20 percent to 24 percent of the workforce. Most are from Mexico, the Philippines, Jamaica, Haiti and the Dominican Republic. About 20 percent of direct care workers are believed to be undocumented immigrants.
Four major categories of visas allow legal admission to the United States for health professionals, but none is exclusive to healthcare workers, researchers noted. Foreign-educated physicians most often come to the U.S. for medical residencies and stay once their training is finished.
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